一名多发性骨髓瘤患者并发急性粒单核细胞白血病：不同克隆起源的证据

Acute myelomonocytic leukemia in a patient with multiple myeloma: evidence for different clonal origin.

作者信息

Nakase K, Tsuji K, Hasegawa M, Suzuki Y, Tamaki S, Tanigawa M, Ikeda T, Miyanishi E

机构信息

Department of Internal Medicine, Yamada Red Cross Hospital, Mie.

出版信息

Intern Med. 1995 Jun;34(6):546-9. doi: 10.2169/internalmedicine.34.546.

DOI:10.2169/internalmedicine.34.546

PMID:7549140

Abstract

A case of 77-year-old female with multiple myeloma (IgG-k) developed acute myelomonocytic leukemia (AMMoL) following a myelodysplastic stage after chemotherapy with melphalancyclophosphamide combinations for 6 years. The leukemic blast cells expressed both myeloid antigens (CD11b, CD13, CD14, CD15, CD33 and CD34) and T/B lymphoid antigens (CD2, CD4, CD22 and PCA1). Cytogenetic analysis revealed a chromosome deletion -7. Analysis of immunoglobulin genes showed the heavy chain genes in germ line configuration. These findings indicate that the AMMoL was a therapy-related stem cell leukemia and was a clonal origin genetically different from multiple myeloma irrespective of plasma cell phenotype.

摘要

一名77岁患有多发性骨髓瘤（IgG-κ型）的女性患者，在用美法仑-环磷酰胺联合化疗6年后经历骨髓增生异常阶段，随后发展为急性粒单核细胞白血病（AMMoL）。白血病原始细胞同时表达髓系抗原（CD11b、CD13、CD14、CD15、CD33和CD34）以及T/B淋巴细胞抗原（CD2、CD4、CD22和PCA1）。细胞遗传学分析显示存在染色体-7缺失。免疫球蛋白基因分析表明重链基因处于种系构型。这些发现提示，该急性粒单核细胞白血病是一种治疗相关的干细胞白血病，并且在遗传学上是一个与多发性骨髓瘤不同的克隆起源，与浆细胞表型无关。